Dr Henry Woo

USANZ 2017 – Dr Henry Woo

Dr Henry Woo @DrHWoo is Professor of Surgery & Discipline Head at the Sydney Adventist Hospital Clinical School, and Professor of Robotic Cancer Surgery & Director of Uro-Oncology at Chris O’Brien Lifehouse.

Professor Henry Woo gives an Australian perspective on minimally invasive treatments for Benign Prostatic Hyperplasia.

Talking Urology podcast transcript

USANZ 2017 Interviews – Henry Woo

This is Talking Urology.

Joseph Ischia: I’m Talking Urology with Henry Woo. He’s going to give us an Australian perspective on Kevin McVary’s talk looking at the minimally invasive treatments for BPH. Henry, how do you respond to, the UroLift is fantastic but it’s got a 23% retreatment rate?

Dr. Henry Woo: It’s very easy to criticize what is seemingly high retreatment rate, but it all comes down to a tradeoff with the benefits associated with that technology. Now, a particular feature of the UroLift technology is the fact that there is no diminution of sexual function. So, therefore, if you have a man for whom sexual function is material concern then they may well be very prepared to accept a 23% or even greater risk of failure at say four or five years.

Joseph: Excellent. Now, you mentioned some other new therapies on the horizon such as the Rezum therapy.

Henry: Yeah, Rezum is a very interesting technology which involves the injection of water vapor and this is then transported through the prostate tissue through a convective heat transfer rather than conductive heat transfer, which is a feature of older versions of heat-based ablative therapies. The data so far has primarily been in glands less than 80 cc and in a similar way to the UroLift it has actually demonstrated preservation of sexual function. The magnitude of improvement in symptom scores is not dissimilar. However, there does seem to be perhaps a slightly improved flow rate improvement compared to what we see with UroLift.

Joseph: So, do we have it in Australia?

Henry: It’s not yet available in Australia but we’re on the brink of having it reach our shores.

Joseph: Excellent. You also spoke about prostatic artery embolization, what are your thoughts on this, Henry?

Henry: When you see results that are too good to be true then quite often that turns out to be exactly the case, but one of the big problems about PAE is the way in which they define technical success as well as clinical success and they use parameters which are not commonly used in the urological literature. So, what interventional radiologists may consider to be a clinically successful outcome does not sort of match what we would necessarily call a clinically successful outcome.

Joseph: Are you seeing many patients around Sydney getting PAE?

Henry: It’s certainly available in Sydney but it’s not being conducted in quite an organized fashion as it is at the Wesley Hospital where there is good cooperation with the urologists.

Joseph: Anything new you’d want to see or think we will see in the near future? What’s on the horizon? What excites you most?

Henry: Well, I have to say the Rezum technology does excite me, but we need more clinical data. I’m especially interested in seeing how well Rezum benefits men in larger glands in particular glands greater than 80 cc. We know with the UroLift it’s challenging with the very large glands. To be fair, it hasn’t been tested in that group and we haven’t seen published outcomes in that but just from my own personal experience, I think that that particular group is going to be a challenge to treat. Now, with Rezum because you’re relying upon the dissipation of water vapor through the gland, intuitively you would think that prostate size is going to be less of a barrier to successful treatment.

Joseph: Excellent, Henry. Thanks very much for your time.

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